Postoperative transient stress urine leakage following Holmium laser enucleation of the prostate is one of the problems that frustrate both surgeon and patients Standard HoLEP might be associated with some stretch of the sphincter and de-epithelization of the sphincter area anteriorly. In Veil preserving HoLEP, early separation of the adenoma from the sphincter ring minimizes sphincter stretch. Furthermore, more proximal incision of the 12 O'clock mucosal strip sparring a veil of mucosa covering the sphincter ring. Our hypothesis is that by this technique the early postoperative transient urine leak would be minimized and duration of leakage if anny would be shortened.
Postoperative transient stress urine leakage following Holmium laser enucleation of the prostate is one of the problems that frustrate both surgeon and patients. Many reports addressed different variables for the cause of post HoLEP urine leakage. Looking for a procedure done by a single surgeon who had tremendous experience of this procedure may enable investigators to identify precisely technical points of interest that may affect post HoLEP stress urine incontinence. Standard HoLEP might be associated with some stretch of the sphincter and de-epithelization of the sphincter area anteriorly. In Veil preserving HoLEP, early separation of the adenoma from the sphincter ring minimizes sphincter stretch. Furthermore, more proximal incision of the 12 O'clock mucosal strip sparring a veil of mucosa covering the sphincter ring. Investigators' hypothesis is that by this technique the early postoperative transient urine leak would be minimized and duration of leakage if any would be shortened.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
180
Early mucosal incision; lateral to the Veru and proximal to the apical bulge of the adenoma, followed by early separation of the adenoma from the sphincter ring after identification of the plane of enucleation, this minimizes sphincter stretch. Furthermore, more proximal incision of the 12 O'clock mucosal strip sparring a veil of mucosa covering the sphincter ring.
Holmium laser enucleation of the prostate in the standard approach described by Elhilali et al 2010
Urology and nephrology center
Al Mansurah, DK, Egypt
urine incontinence
one hour pad test for post prostatectomy incontinence, scale from 0 to 4, the higher the more incontinence
Time frame: 1 month postoperative
international prostate symptom score
Symptoms core assessment, score from 0 to 35, the higher the worse the urinary symptoms
Time frame: 1 year
urine flow rate
rate of urine flow per unit time, how many milliliters of urine passed per second, above 15ml/second is normal
Time frame: 1 year
urine incontinence
one hour pad test for post prostatectomy incontinence, scale from 0 to 4, the higher the more incontinence
Time frame: 4 months postoperative
International Consultation on Incontinence Questionnaire Short-Form
Continence core assessment, score from 0 to 21, the higher the worse the urinary continence
Time frame: one month postoperative
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